Is this ADHD or is it the menopause?

With the menopause featured in the news much more prominently in 2022 more attention has been drawn to the fact that menopausal symptoms can mimic those of ADHD, so how do we know which we are being affected by?

Menopause can bring on mood swings, brain fog, disorganisation, periods of self-doubt, anxiety and forgetfulness which are all conditions very familiar to those already diagnosed with ADHD, but what about those who are not?

During the lockdown, whilst working from home, many clients have realised how much they feed upon the energy of their co-workers to keep them alert and on track with what they are meant to be doing. Suddenly faced with self-isolation and attempting to work alone, they have found motivation nearly impossible and have been faced with routine administrative tasks backing up to the point where they found it impossible to start doing anything.

This is because the hormone oestrogen also acts upon that area of the brain governing executive function - allowing us to be organised and complete tasks that we have started. As the levels diminish during menopause, the neurotypicals amongst us start to get a taste of everyday ADHD life.

One of the key features of ADHD counselling can be to find the way in which clients can get started, how to break down tasks, and build in rewards so that they can stay engaged. Medication can be extremely helpful with just getting people with ADHD off the starting blocks, however, even getting a referral for assessment is a hurdle in itself.  I have worked with clients who have approached their GP only to be turned away with comments such as:

"It can’t be ADHD, you’ve done very well for yourself."

"You’ve got a degree, you wouldn’t have been able to do that with ADHD."

"You’re just suffering with anxiety, everybody gets that."

Of course, none of these statements are true, but GPs routinely get very little training in mental health issues.

Getting an ADHD diagnosis 

If you have completed one of the online test indicators for adult ADHD, and it does suggest that you might benefit from being tested, show these results to your GP.  If they still refuse, ask for a second opinion from another GP in the practice.  The GP should carry out tests for thyroid function routinely which can cause brain fog and sluggishness, as can low levels of Vitamin D.  Many parents find themselves being diagnosed following the diagnosis of one of their children, and then recognising the same symptoms in themselves.

A second challenge to diagnosis is getting somebody who has known you preferably from childhood, often a parent, to complete the diagnostic questionnaires which the psychiatrist sends out, truthfully. Time and again in schools as an ADHD-er myself, I would see undiagnosed pupils in counselling who had never had the chance of assessment because one of the parents was not in agreement that their child was struggling - brushing their concerns off with "oh, he’s just being a boy" or "no, she just takes after her mum, she’s away with the fairies at times."  

Remember, if a parent has been extremely strict or punitive during your childhood, a positive diagnosis in adulthood for you can bring huge feelings of guilt to them which they would rather not confront. Recognition that those parents may have become that way because of their own ADHD really gets you looking at your whole family tree, being able to explain the behaviour of certain aunts or uncles, and can bring on a real sense of grief for the loss of potential.

There are many positives too, people are never bored in the company of somebody with ADHD.  If you need somebody to think outside the box, play devil’s advocate for a new project or practice you are introducing, or take complete control in seconds in the face of an emergency, the ADHD-er if your gal. I once had an ADHD t-shirt boldly proclaiming "ADHD, I have more ideas before breakfast than you have in a week!"

The message here is, rest assured, it may not all be in your head! And for all of you for whom it is menopausal, have a little understanding of those of us who have tried to live with this for life.